It’s easy to be intimidated by a Medicaid application. You have to provide much information and satisfy many strict regulations. Knowing a little more about the process – especially in the form of tips from experienced people – can really help.
Know What Benefits Are Available
Before starting the whole application process, check out Medicaid’s programs. Do any of the programs meet your needs? Will the services offered meet your individual needs?
For example, Alabama Medicaid covers many services, including:
Dental services, but only for an applicant who receives full Medicaid. Only certain age groups may be eligible.
Doctor Appointments. Medicaid typically pays for 14 visits each year. Will you need more than 14 visits?
Family planning services. Some of the services are only available to men or women over age 21.
Transportation – Ambulance. Medicaid will only pay for transportation when it is medically necessary.
Of course, this list is not complete. Medicaid offers other services with restrictions and limitations, so confirm that you can get the help you need.
Make Sure You Qualify
Talk over your financial situation with your attorney. To qualify for Medicaid, you have to be careful not to exceed income and resource limits. With careful estate and financial planning, you may be able to increase your chances of Medicaid approval.
Get the Application Right the First Time
Probably one of the best ways to have your application denied is to submit incorrect or incomplete paperwork. You will submit quite a few supporting documents, as well as the application itself. In fact, Medicaid expects to review five years of financial data.
Talk to an Experienced Medicaid Attorney
This may be the best way to get your application approved. However, an Alabama Medicaid attorney can do more than get you through the application process. Medicaid planning should begin years before you actually apply for Medicaid. It’s in your best interests to consult with a lawyer as soon as possible.
Contact us at 256-472-1900 for a free consultation. The attorneys at Miller Estate and Elder Law know how to help you with Medicaid planning and with estate recovery concerns.
Also, receive a free download of Medicaid Planning in Alabama: What You Need to Know by clicking here.
Benefit programs like Medicaid often include strict requirements and rules. To qualify for Medicaid, for example, an applicant must show a financial need by staying below Medicaid’s income and resource limits. However, some people need Medicaid benefits but exceed the amounts Medicaid allows. In this article, we will look at those limits, and, more importantly, how to spend-down your assets and monthly income to meet them.
Medicaid Limits on Income and Resources
A nursing home resident typically can possess no more than $2,000 in resources as of the first day of the month.
However, Medicaid does not count all of your assets and income. Some resources might be considered as countable, including cash, real estate, and one automobile per household. The status of some assets may change in certain situations. For example, real estate held as a life estate or that is on the market may not be counted.
It’s to your benefit to consult with an experienced attorney before applying for Medicaid or attempting any sort of spend-down activities.
Planning a Spend-Down
After learning you may not qualify for Medicaid because of income and asset limits, you may want to plan a spend-down of your assets. But how exactly do you go about doing this? Here are some important considerations:
Where are you living?
Are you married or single?
What is the source of your income?
What type of assets do you have?
The answers to these questions may make a difference in how you spend proceed. Make sure your lawyer has all the information needed to advise you about spending down your assets.
Actions That Spend-Down Your Assets and Monthly Income
After carefully assessing your resources compared to Medicaid’s requirements, you may start taking some of the following steps:
Pay your medical bills. Certain medical bills can be paid to reduce your countable cash assets. In addition to your own, you may be able to pay medical bills for your spouse and your children. You can pay past and current medical expenses, which may include transportation costs, therapists, personal care attendants, home health aides, rehabilitation programs, prescription drugs, and medical equipment ordered by a doctor.
Pay off other debts. You may be eligible to use excess income to reduce mortgage, auto loan, and credit card balances.
Sell certain assets. In some situations, countable assets may be sold to pay off medical bills and debts to reduce a recipient’s resources.
Set up a Miller Trust. Excess monthly income can be diverted to a Miller Trust to stay below Medicaid’s monthly income and resource limits. Funds in the Miller Trust can be used for eligible expenses.
Keep in mind that transferring, selling, or spending assets may result in reductions or delays in benefits.
Spend-Down Your Assets and Monthly Income Wisely
The rules are complicated. Always speak with an experienced attorney before trying any kind of spend-down strategies.
Tom knew his dad, Frank, was having a little trouble taking care of himself at home. He dreaded the idea of putting his father in a nursing home, even though he knew of several wonderful homes nearby. Frank wanted to remain independent at home for as long as possible. One day, however, Frank’s doctor told Tom that Frank should have supportive devices, special transportation, assistance with taking medication, and help with his daily activities. As Tom helped his dad deal with the changes in his life, he learned that Medicaid can help every step of the way. The first step was finding out that nursing care was needed.
Step two is finding out how Medicaid can help your loved one stay at home. Keep in mind that some Medicaid programs cover home health and institutional care.
Home-Based Long-Term Care
Medicaid is a federally-funded, state-run program that provides healthcare to qualified individuals. However, Medicaid is not just one program. Instead, various programs are offered to help different segments of our society. People like Frank need advanced care but may be eligible for Medicaid programs that meet their medical, nursing, and social needs without leaving home. Medicaid home health programs include:
Home Health Care. Eligible people of any age, including elderly, may be qualified to receive Medicaid home care
Home and Community-Based Waivers. Eligible Medicaid recipients must be at risk for moving to institutional care, yet willing to receive that care at home.
At some point, people may be ready for step three.
Transitioning to Institutional Care
Moving from home to nursing home can be difficult. Medicaid programs offer services and financial aid to make the move a little easier.
Medicaid for the Elderly and Disabled (E&D). The services offered through E&D assist people who live at home and in nursing homes, hospital, and other residential facilities.
Medicaid in the Nursing Home (Institutional Medicaid). This program provides coverage of institutional care for people who qualify.
Medicaid For the Various Phases of Life.
In addition to programs that help people move to an institutional setting, Medicaid also offers a program to help people move out of nursing homes. Gateway to Community Living offers services and support for qualified individuals who wish to move from an institution to a home setting.
Contact Bill Miller at 256-251-2137 to schedule an appointment. The attorneys at Miller Estate and Elder Law can help with applying for Medicaid. Even better, we can help you with Medicaid planning to increase your chance of getting Medicaid and keeping as much property as possible. Though our office is now located at 818 Leighton Avenue in Anniston, we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
Will Medicaid take my home or will Medicaid take my house are two of the most common questions I get when someone is entering the nursing home and trying to qualify for Medicaid. This is understandable since people’s homes are obviously very important to them. Many times, the home is a persons most valuable asset. They do not want to lose their home if they apply for Medicaid and have to go into a nursing home to pay for their long term care costs.
Medicaid Does Not Actually Take Anything
It is important to understand that Medicaid does not actually take anything from a person who applies for Medicaid. Medicaid will just not pay unless you have spent all of your assets down to a certain amount. Medicaid has asset limits and will not pay if you have more than the limit. A single individual cannot have more than $2,000 in assets; a married person who is not going into the nursing home can keep one half of the total assets up to $128,420. Because of the assets limits, it is not uncommon for people to wonder will medicaid take my home.
Will Medicaid Take Your Home – No, but They Will Put a Lien on It
If you are married and your spouse continues to reside in the home, the home is exempt and you could qualify for Medicaid with no risk to your home. If you are single, on the other hand, you can still qualify for Medicaid, even you have a house, but Medicaid is going to put a lien on the home for any amount of money that they pay on your behalf. Then, when you pass away, Medicaid is entitled to be reimbursed for any amount of money they have paid for your care. The problem is that often the Medicaid lien will exceed the value of your home when you pass away. If so, then your family would not get any money from your home. There are ways to protect your home, but it takes advanced planning. If you have asked yourself “Will Medicaid Take my Home” you are not alone. This is a common concern for someone entering the nursing home.
We have helped many families protect their homes and other assets. Let us help you – call us today at 256 251-2137.
Giving away assets to qualify for Medicaid is a strategy that many people use when they are concerned that they might be going into a nursing home because they think it will help them qualify for Medicaid more quickly. Unfortunately, giving away assets usually involves way more risks and harm than good.
Medicaid has a 60 Month Look Back
Medicaid has a 60 month look back from the time you file your Medicaid application. Therefore, if you’ve given away any assets within the 60 months prior to filing your application, Medicaid is going to penalize you for those giveaways and you won’t qualify. The penalty is based on how much money you gave away during the 60 months prior to the application. The penalty is calculated by taking the amount given away and dividing that by a monthly divisor which is set by Medicaid each year. For example, if you have given away $64,000 within the past 60 months and the Medicaid penalty divisor is $6,400, Medicaid will impose a 60 month penalty.
There are More Risks Than Rewards When You Give Assets Away
The other problem with giving away assets is that once you give them away you no longer have control over them. Whoever you give the assets to has potential creditors and predators and your assets are now subject to those creditors. Most people say well, my son or my daughter would never do anything with my assets. However, what if they get sued? What if they get a divorce? What if they have to file bankruptcy?
Once you give your assets away to that person, then your assets are now subject to their bankruptcy filings, divorces, lawsuits, etc. I’ve seen more people than I can count unfortunately who used this strategy and had to go into a nursing home and the assets were no longer there and they couldn’t get the care that they needed. While there are strategies to protect assets from long term care costs, giving them away to relatives is not something that I recommend. There are better ways to accomplish the same objective without the risks.
Do I Have to Wait 60 Months to Qualify for Medicaid?
One of the most frequent questions that I get as an elder law attorney when someone’s trying to apply for Medicaid to get in a nursing home, is, “Do I have to wait 60 months to Qualify for Medicaid?” And the answer is, “No.”
The Medicaid Look Back Period is Different from the Medicaid Penalty Period
60 months is simply the look-back period, or the amount of time that Medicaid looks back to see if you’ve given any assets away or if you have sold assets for less than fair market value. So, when you file the application, you have to meet the financial requirements which I’ll address in another video. But once you meet those financial requirements then Medicaid is also going to look back 60 months to see if you’ve given away any assets during that time.
If you have given away assets during the past 60 months, then they’re going to penalize you based on the amount of money that was given away. The penalty period is determined by the amount of money you gave away divided by a divisor that is put out by Medicaid. The Medicaid look back period of 60 months is the same for everyone. The penalty period is different for everyone. However, there is no Medicaid 60 month rule that says you have to wait 60 months to apply for Medicaid. Most of our clients don not wait 60 months. We even have clients who are already in a nursing home and we can help them protect some of their assets.
if you have any other questions, watch the other videos or give us a call 256 472-2172. I look forward to meeting you.
